https://www.mayoclinic.

org/diseases-conditions/cataracts/symptoms-causes/syc-
20353790#:~:text=Most%20cataracts%20develop%20when%20aging,increase%20your%20risk
%20of%20cataracts.
Cataract is a clouding of the normally clear lens of your eye. For people who have
cataracts, seeing through cloudy lenses is a bit like looking through a frosty or fogged-
up window. Clouded vision caused by cataracts can make it more difficult to read, drive
a car (especially at night) or see the expression on a friend's face.
Most cataracts develop slowly and don't disturb your eyesight early on. But with time,
cataracts will eventually interfere with your vision.
At first, stronger lighting and eyeglasses can help you deal with cataracts. But if
impaired vision interferes with your usual activities, you might need cataract surgery.
Fortunately, cataract surgery is generally a safe, effective procedure.
Symptoms
Signs and symptoms of cataracts include:
 Clouded, blurred or dim vision
 Increasing difficulty with vision at night
 Sensitivity to light and glare
 Need for brighter light for reading and other activities
 Seeing "halos" around lights
 Frequent changes in eyeglass or contact lens prescription
 Fading or yellowing of colors
 Double vision in a single eye
At first, the cloudiness in your vision caused by a cataract may affect only a small part of
the eye's lens and you may be unaware of any vision loss. As the cataract grows larger,
it clouds more of your lens and distorts the light passing through the lens. This may lead
to more noticeable symptoms.
Causes
Most cataracts develop when aging or injury changes the tissue that makes up your
eye's lens.
Some inherited genetic disorders that cause other health problems can increase your
risk of cataracts. Cataracts can also be caused by other eye conditions, past eye
surgery or medical conditions such as diabetes. Long-term use of steroid medications,
too, can cause cataracts to develop.
How a cataract forms
The lens, where cataracts form, is positioned behind the colored part of your eye (iris).
The lens focuses light that passes into your eye, producing clear, sharp images on the
retina — the light-sensitive membrane in the eye that functions like the film in a camera.
As you age, the lenses in your eyes become less flexible, less transparent and thicker.
Age-related and other medical conditions cause tissues within the lens to break down
and clump together, clouding small areas within the lens.
As the cataract continues to develop, the clouding becomes denser and involves a
bigger part of the lens. A cataract scatters and blocks the light as it passes through the
lens, preventing a sharply defined image from reaching your retina. As a result, your
vision becomes blurred.
Cataracts generally develop in both eyes, but not evenly. The cataract in one eye may
be more advanced than the other, causing a difference in vision between eyes.
Types of cataracts
Cataract types include:
Cataracts affecting the center of the lens (nuclear cataracts). A nuclear cataract may at
first cause more nearsightedness or even a temporary improvement in your reading
vision. But with time, the lens gradually turns more densely yellow and further clouds
your vision.
As the cataract slowly progresses, the lens may even turn brown. Advanced yellowing
or browning of the lens can lead to difficulty distinguishing between shades of color.
Cataracts that affect the edges of the lens (cortical cataracts). A cortical cataract begins
as whitish, wedge-shaped opacities or streaks on the outer edge of the lens cortex. As it
slowly progresses, the streaks extend to the center and interfere with light passing
through the center of the lens.
Cataracts that affect the back of the lens (posterior subcapsular cataracts). A posterior
subcapsular cataract starts as a small, opaque area that usually forms near the back of
the lens, right in the path of light. A posterior subcapsular cataract often interferes with
your reading vision, reduces your vision in bright light, and causes glare or halos around
lights at night. These types of cataracts tend to progress faster than other types do.
Cataracts you're born with (congenital cataracts). Some people are born with cataracts
or develop them during childhood. These cataracts may be genetic, or associated with
an intrauterine infection or trauma.
These cataracts also may be due to certain conditions, such as myotonic dystrophy,
galactosemia, neurofibromatosis type 2 or rubella. Congenital cataracts don't always
affect vision, but if they do they're usually removed soon after detection.
Risk factors
Factors that increase your risk of cataracts include:
 Increasing age
 Diabetes
 Excessive exposure to sunlight
  Smoking
 Obesity
 High blood pressure
 Previous eye injury or inflammation
 Previous eye surgery
 Prolonged use of corticosteroid medications
 Drinking excessive amounts of alcohol
Prevention
No studies have proved how to prevent cataracts or slow the progression of cataracts.
But doctors think several strategies may be helpful, including:

Have regular eye examinations. Eye examinations can help detect cataracts and other
eye problems at their earliest stages. Ask your doctor how often you should have an
eye examination.
Quit smoking. Ask your doctor for suggestions about how to stop smoking. Medications,
counseling and other strategies are available to help you.
Manage other health problems. Follow your treatment plan if you have diabetes or other
medical conditions that can increase your risk of cataracts.
Choose a healthy diet that includes plenty of fruits and vegetables. Adding a variety of
colorful fruits and vegetables to your diet ensures that you're getting many vitamins and
nutrients. Fruits and vegetables have many antioxidants, which help maintain the health
of your eyes.
Studies haven't proved that antioxidants in pill form can prevent cataracts. But, a large
population study recently showed that a healthy diet rich in vitamins and minerals was
associated with a reduced risk of developing cataracts. Fruits and vegetables have
many proven health benefits and are a safe way to increase the amount of minerals and
vitamins in your diet.
Wear sunglasses. Ultraviolet light from the sun may contribute to the development of
cataracts. Wear sunglasses that block ultraviolet B (UVB) rays when you're outdoors.
Reduce alcohol use. Excessive alcohol use can increase the risk of cataracts.

URL:https://www.southerncross.co.nz/group/medical-library/cataracts-causes-symptoms-
treatment-surgery
Diagnosis
Either a GP or optometrist may make an initial diagnosis after testing your vision and examining
your eyes.
If cataracts are suspected, a referral to an eye specialist (ophthalmologist) is usually
recommended. The eye specialist may carry out more detailed examinations of the eye and
vision in order to determine the exact location and extent of the cataracts. They will then
recommend appropriate treatment.
Cataracts can be classified according to which part of the lens they affect. The location and
extent of the cataract also determines the extent of the vision impairment. For example, vision
may be significantly impaired if the centre of the lens is affected (nuclear cataracts); however, if
the edges of the lens are affected (cortical cataracts) vision impairment may be barely
noticeable.

Treatment and surgery

The symptoms of early cataracts may be improved with new prescription glasses and stronger
lighting. However, once cataracts progress to the point that impaired vision reduces your
quality of life and interferes with daily activities, surgery is the only effective treatment.
Cataract surgery involves removing the clouded lens and replacing it with a clear plastic lens
known as an intraocular lens (IOL). The aim of surgery is to restore vision (particularly distance
vision) as much as possible. IOLs of differing magnifying power can be used to help correct pre-
existing short-sightedness (myopia), long-sightedness (hyperopia), or problems with the shape
of your cornea (astigmatism).
Cataract surgery is most commonly performed as a day-stay procedure and is usually carried
out under a local anaesthetic with mild sedation.
Surgery involves making a small incision in the front of the eye, through which the old lens is
removed and the artificial IOL is inserted. The incisions are usually made using a hand-held
microscopic blade but, in recent times, laser cataract surgery has allowed computer-guided,
bladeless incisions to be made.

Laser cataract surgery should not be confused with laser eye surgery (PRK and LASIK), which is
used to correct problems with the eye's ability to focus.
If cataracts affect both eyes, only one eye is operated on at a time. It is usually recommended
that the eye is well healed before the other eye is treated. This is generally at least one month.
Recovery
Patients are normally sent home after a few hours of recovery in the clinic or hospital, and
when the sedation has worn off. An eye pad is usually positioned over the eye for the first night
in order to protect the eye.
It is usual to feel some mild pain and discomfort in the eye after cataract surgery. This can
usually be well controlled with medications such as paracetamol.
While it may take a day or two for the eyes to synchronise, people generally report that vision
improves quickly, being able to return to normal activities within about two weeks. Distance
vision returns but reading glasses will still be required for fine or detailed visual tasks.

Complications
Cataract surgery is generally safe and the risk of developing serious complications is small.
The most common complication is a condition called posterior capsule opacification (PCO),
which involves a skin or membrane growing over the back of the lens implant months or years
after surgery causing vision to become cloudy again. PCO can be treated with a simple laser eye
surgery to cut away the membrane.
Cataract surgery also carries a risk of infection and bleeding inside the eye and increased risk of
retinal detachment. However, most complications can be treated with medication or further
surgery.
Prevention
Cataracts cannot be prevented. However, certain approaches may delay or reduce the chances
of them developing.
Wearing sunglasses that protect the eyes from ultraviolet light is recommended. A diet high in
fruits and vegetables, limiting alcohol use, and quitting smoking are also thought to be
beneficial.
Optimal management of health conditions that can increase the risk of developing cataracts
(eg: diabetes) is advised. If corticosteroids are being taken on a long-term basis, it is
recommended that a GP or optometrist checks the eyes regularly for signs of cataract
development. Even if corticosteroids are not being taken, regular eye examinations are advised
for those over 40 to detect cataracts and other eye problems at their earliest stage of
development.
URL: https://www.healthinaging.org/a-z-topic/cataracts/care-treatment
Cataracts are a common result of aging and occur frequently in older people.
About one in five adults over the age of 65 has a cataract. Cataracts are a
clouding and darkening of the eye lens, which blocks vision. Stronger lighting
and eyeglass adjustments can help when cataracts are small. As cataracts grow,
many people need surgery.
Prevention
Research suggests that you may be able to lower your risk of cataracts, or slow
down their formation, by following the below recommendations.
See your eye doctor regularly. Ask your healthcare provider how often you
should have an eye exam.
Quit smoking. Your healthcare provider can help you find the best way to quit.
Wear sunglasses. Sunglasses can block ultraviolet B (UVB) rays when you are
outdoors. You can also wear a broad-brimmed hat to block the sun.
Take care of other health problems. This is especially important if you have
diabetes or other medical conditions that can increase your risk for cataracts.
Eat plenty of fruits and vegetables. Try to eat colorful fruits and vegetables, which
have the most vitamins, minerals, antioxidants, and other nutrients.
Treatment
In mild cases
If your cataracts are small and not bothersome, simply using eyeglasses or
contact lenses, anti-glare glasses, or magnifying lenses may be all that you need.
Follow all the steps listed above in the Prevention section to slow down cataract
growth. Have regular check-ups with your eye doctor. You may not need cataract
surgery for several years. In fact, you may never need surgery.
Make sure that your eyeglasses or contact lenses have an up-to-date and
accurate prescription. This will help you deal with cataract symptoms until
surgery is necessary.

When to consider cataract surgery

Most eye doctors recommend cataract surgery if your quality of life or ability to
perform normal daily activities are affected (such as reading, watching TV, or
driving at night).
In some cases, you may need to have a cataract removed even if it is not affecting
your vision. For example, if the cataract blocks the examination or treatment of a
different eye disease such as age-related macular degeneration, or diabetic
retinopathy.
Surgery
Cataracts can only be cured by surgical removal. Cataract surgery has been
carried out safely and effectively for many decades. It is one of the most common
operations performed in the US. For 9 out of 10 patients, vision improves after
surgery, and visual acuity is usually 20/40 or better. Cataract surgery has also
been found to enhance mental outlook, ability to carry out daily functions, and
quality of life in general.
If you decide to have surgery, your doctor will perform some tests and eye
measurements a few days before. You may have to stop taking certain
medications temporarily. In addition, you must not eat or drink for twelve hours
beforehand.
The operation usually takes less than 30 minutes and is performed under local
anesthetic or a topical preparation applied directly to the eye. You will probably
be awake during the surgery. It is an outpatient procedure, so you will come
home the same day. If you have cataracts in both eyes, you will normally have
one eye done at a time with a period of a few weeks between surgeries.
The two types of cataract surgery are:
Phacoemulsification (phaco) or “small incision cataract surgery.” This is the
most common method. In phacoemulsification, your surgeon makes a small
incision on one side of your cornea, the covering on the front of your eye. The
surgeon inserts a tiny probe through the incision that emits extremely high sound
waves. This breaks up the discolored lens so that it can then be easily removed
by suction. The surgeon will replace your old lens with an artificial plastic lens,
called an intraocular lens (IOL).
Extracapsular surgery. If the surgeon decides to use extracapsular surgery, a
larger incision will be made on your cornea and the core of the lens will be taken
out in one piece. Suction is used to remove the rest of the lens. The surgeon will
replace your old discarded lens with an IOL.
The IOL becomes a part of your eye, fulfilling the same function as your old lens
when it was healthy. You won’t feel any difference. If you are not able to have an
IOL because of another eye condition or problems during surgery, you may use a
special soft contact lens, or high-magnification glasses, after your own
discolored lens is removed, to make up for the missing lens.
After the operation, your eye will be covered with a patch and you will rest while
the medical team monitors you for any problems, such as bleeding. You will not
be able to drive home after the operation and will need someone to help take you
home. There may be some mild pain which should be gone within a day or two.
You will probably be told to use eye drops for a few days, and must avoid rubbing
or touching your eyes, bending from the waist, or lifting anything heavy.
Although cataract surgery is usually very safe, as with any surgery, there is
always a risk of infection and bleeding. Cataract surgery also increases the risk
of a detached retina, which must be treated immediately to avoid serious vision
loss. If you have a sudden increase in flashes or floaters, inform your provider
immediately. This may be a sign of retinal detachment and must be treated as a
medical emergency.
In about 15% of people, a part of the eye called the posterior capsule becomes
cloudy within three years of cataract surgery. This is called an “after-cataract”
and can easily be corrected using a special laser. No surgery is needed.